The importance of contraception is something I feel I know my way around; I went to Nepal with Save the Children slightly sceptical about the idea that you need to see it to believe it. I already believe it, but what you see is not what you expect. On the face of it, you would recognise in Nepal everything you have ever heard about the way women are treated outside the West: A third of marriages feature one participant under 15, usually the girl; They still practise chhaupadi in some rural areas, which means that when you are menstruating, you are considered so unclean that you have to go and live in a shed. I thought that was a lot worse before I saw the sheds, which look just like living quarters, except that they tend to be downstairs and have a cow in them; There are villages where, even if you are raped, the act of intercourse results in you being de facto married to the rapist.
Yet, it does not feel that strict — I sat in on a meeting of health visitors undergoing training from a guy who said their BCG vaccination rates were not high enough and they erupted. They said they had vaccinated everybody and they were not meeting their targets because the census data was wrong and that was because — well, it is a labyrinthine story involving Maoists. What struck me is that this is not a place where women are subservient.
Plus, there is no taboo around contraception and since the surest way to keep women subjugated is to give them no control over when they have children, if that does not suggest a degree of equality, then it is a hell of an oversight.
Photo: EPA
The charity Save the Children supports this network of health workers, who survey their environs like hawks, making sure everybody has the contraception they need, but that is not the limit of the provision — you can end up among some vending shacks near a river, a shopping parade with margins so slim that they are trying to recycle your Coke bottle while you are still drinking it, and there will be a pharmacist trained to give LARC (long-acting reversible contraception) injections, with heavily subsidised pills (12 rupees for a month) and overflowing with condoms called Panther.
“It is not Afghanistan,” the NGOs say, as a kind of pep-talk-cum-mantra — it might look hard, improving the maternal outlook in a country that is so poor, but at least it is not Afghanistan.
So these are the issues: When you marry, you have to leave school and take on all the household duties for your husband’s family. “I wasn’t expecting the work,” said Nisha Darlami, who had married at the age of 13 and is now 19. “Before, I’d only had to cook and cut the grass. [When I arrived with my in-laws] I had to do everything, from the minute the cattle woke up.”
It is almost like a fairytale in its suddenness and non-negotiability — you have a mother-in-law who has been doing all the work since she arrived, and she has been waiting maybe two decades for you to arrive. Given this handover, I was amazed at how well the daughters and mothers-in-law seemed to get on, but it is possible that fighting in front of strangers is a universal taboo.
The reality of child marriage borders on child slavery, but interventions are vexed: Even though it is illegal, enforcement is flaky. Since 2008, there has been a more concerted campaign and arranged marriages are becoming rarer.
When girls of 13 and 14 get pregnant, the results are often brutal. Their own health is dicey throughout pregnancy and the babies are often painfully small. It was not unusual to meet girls who had had babies weighing 0.9 to 1.2kg, at full term. Stillbirths and maternal deaths in labour are common. The mothers can get uterine prolapse or fistula later on. It clearly caused some soul-searching for Save the Children to get involved in an initiative that prevented, rather than saved, any fresh children, but it is a signal of how important this is; children do not win from a cultural norm that results in ill babies — nobody wins. Plus, the mothers are children, too.
Family planning has rocked and will continue to rock this society — the changes will not stop at smaller family sizes and lower infant mortality and higher female literacy and better maternal health. The new possibilities enliven the children’s clubs, where kids between about 10 and 18 gather to campaign, mainly against child marriage, but also for access to contraception.
Anybody who has ever had any doubts about the children’s rights agenda — whether it’s possible to airdrop the idea of rights into a culture that isn’t individualistic — should see one of these meetings, housed in a stuffy room with a drawing of fallopian tubes on one wall and a portrait, copied from a photograph, of Yuri Gagarin on another. The kids sing us a song about child marriage (one bit translates: “Getting married as a child ruins your chances in life / and you also risk a uterine prolapse” — in Nepalese, that rhymes), and then describe the work that they do, persuading determined Romeos and Juliets to wait, picketing wedding ceremonies, spreading the message that life could be better, lived another way. As we leave, they ask us what they could learn from young political activists in the UK, and we are totally stumped. Nothing. Maybe how to play Angry Birds.
If you think family planning is not a children’s issue, you just have not met enough children.
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